Coronavirus Bad Look at Grandview Medical Center ER in Birmingham, Alabama

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I lost most of yesterday going with my 92 year old mother to the ER at Grandview Medical Center. As you’ll see shortly, this misadventure shed light on some coronavirus issues. If medical professionals aren’t being vigilant about coronavirus risks in one of the few places in Alabama that had some sensible post-lockdown provisions that unfortunately weren’t in place all that long (mandatory masks in public), God forbid where the state and other red states will be in a month.

My mother fell two nights ago. In her carpeted bedroom, she bent down to pick up something off the floor using her little walker for support, even though I have repeatedly told her never to pick up anything from the floor, to leave it or call me. The walker fell over and she fell partly on it.

She seemed more bruised than anything but was also very badly shaken up, particularly since it took some doing for me to hoist her off the floor. She was quite banged up on one shin, and on one side from her mid waist to hip. My hypothesis was that she’d badly bruised her floating rib and the general area.

She had pain only when lying on that side and when going from lying down to sitting or vice versa. The next day, once she finally got out of bed (she’d slept very badly due to difficulty of finding a good position; she normally sleeps on her damaged side.

We had a home duty nurse come in to give her a look, which happened a day later than it should have, meaning yesterday. The nurse did a pretty thorough exam, thought she was OK, no sign of internal damage, not too much soreness where she poked.

By happenstance, the aide and I sat Mom up in bed so she could stand before the nurse left. The nurse didn’t like how painful that was. The nurse though she might have a hip fracture or a fractured floating rib and wanted her checked out. I was resistant due to coronavirus risk.

The nurse and one of the managers at the agency (also a nurse) recommended Grandview Medical Center as being the least exposed hospital. So off to the ER.

We had a series of not good incidents on the coronavirus front on the way to my mother getting diagnosed.

I rode in the ambulance in the front seat. Driver was not wearing a mask.

At the ER, there was a tent next to the entrance with clear plastic sheeting on its front side. I asked if that was for coronavirus testing. No, I was told it was for coronavirus screening before entering. I would assume that would normally consist of at least taking temperatures. But no one was there and the EMTs seemed a little puzzled that we breezed in.

I’m used to ERs where patients are registered immediately and screened for triaging purposes. Then you sit around and wait. Here, even though my mother was strapped into a gurney, the two EMTs rolled her about 3 feet from a long counter that had work spots behind and below it, with more workspaces behind. Not all the spots were filled but about a half dozen were, and all but one was wearing medical scrubs and masks (the woman dressed in non-hospital garb was also masked).

No one else was in intake limbo. Normally, I would have acted like a New Yorker and found out what was up and what the process was, but the ambulance guys acted as if this was normal. They’d also told me I wasn’t supposed to be there and I would be shooed to the lobby, but that never happened (I’ve never heard of an ER not allowing an immediate relative to participate in intake and seeing the doctor).

While I was parked on a chair, waiting, someone in scrubs came though the lobby, sweeping up odds and ends. His mask was pulled down well below his nose.

After we got done with the imaging (results seemed to be the least bad of possible bad outcomes1) we had more fracas getting me back home than anticipated. The nurses earlier in the day had recommended that a ambulance take her back, if nothing else to have a couple of strong guys wheel back to her bed and put her in it. They’d assumed I could ride back.

No dice. Five ambulance companies refused, including the one that had given me the ride out. So I had to call and wait a LONG time for a cab, well after the ambulance had left.

So your humble blogger was back in the ER intake open area where I was not supposed to be, in a chair off to the side by the entrance doors so as to be out of the way.

Someone wheeled in a gurney with a very old woman in it, pallid and with her eyes closed. The EMT, who was standing next to her, was not wearing a mask, and she wasn’t either. Both were less than six feet from me.

I cleared my throat and said by putting her so close to me, he was endangering her. This was the only way I thought to get the idea of “endangering her” in without calling him out directly for not wearing a mask.

Maskless EMT instead told me to move. I informed him I am injured (true) and there was nowhere else to sit. He refused to shift the gurney even though there was plenty of room for him to scoot it a couple of feet.

So, screwing my joints up in the process, I hauled the two heavy and one heavy-ish bags I’d brought (laptop, charger, book, stuff my mother would need if she was admitted), the chair, and me through the inner set of sliding glass doors and sat in the little vestibule between them and the outer glass doors.

You’d think moving furniture to a place it was ostentatiously not supposed to be, in full view of the hospital staff walking through the intake area and even some in the seats, might get some notice of the “You aren’t supposed to be there” sort, allowing me to complain about the latest incident of maskless medical staffers in their facility, and ask why weren’t they doing something about it.

Instead, after a while, a nurse came to tell me my cab was coming and helped me get to the main lobby.

This casualness about mask discipline in a hospital is jarring. I can’t tell how much of this behavior is about this hospital versus the South generally. I did tell this story to a colleague who knows a California teaching hospital well, and he was shocked.

Birmingham is already getting overflow coronavirus cases from Montgomery, which is just about out of ICU beds. So it looks like a hot and sickly summer is around the corner.

______

1A CAT scan showed acute fracture in her third lumbar vertebra.

Weirdly that is less bad than any other problem they could have found. A hip fracture would would mean an operation even if all they did was put a pin in her. I’m leery of general anesthesia for old people. It appears in some cases to worsen cognitive decline.

There is not much to do except for her to wear a back brace and take pain meds. I was pushy so she got both before she left.

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54 comments

  1. vlade

    “overflow coronavirus cases from Montgomery, which is just about out of ICU beds”.

    As you say, I think the US is in for some fun. The good news seems to be that sun does kill it, the bad news is that the sun even in the South doesn’t last whole year. November elections could be a perfect super-spreader event.. (unless Trump seems to be losing it and finds it as an excuse to move the date, or at least try to).

    Reply
    1. Redlife2017

      On your slight concern around moving the US election date, the US constitution in Article II, Section 1, Para 4 state: “The Congress may determine the Time of chusing the Electors, and the Day on which they shall give their Votes; which Day shall be the same throughout the United States.” So unless Nancy Pelosi also agrees, I’d call that a probable no-go.

      Now, saying that…I suppose Trump could get some of the red states to nullify the day that Congress has set. Nullification has very bad vibes to it in the US…The last time mass nullification was tried looks to be the 1950s with the cases of desegregation. And the Supreme Court slapped that down. But if they don’t listen to the Supreme Court? Uhhh…that’s what the Civil War was about…

      Reply
      1. ambrit

        Well, some states did try to enact small scale nullification, such as George Wallace and his standing in the schoolhouse door in 1963.
        See: https://www.youtube.com/watch?v=YgbNc-9Di7k
        Luckily, Johnson was willing to “lose the South for a generation” and did not shrink from using the National Guard to enforce desegregation.
        Show me one major politician today willing to be that firm in his or her resolve.
        We need leaders, not Corporate Spokespersons.

        Reply
    2. NotTimothyGeithner

      Maybe not the election, but central Virginia has almost 25 cloudy days in November. It’s bleak. I would look at Thanksgiving, especially if Trick or Treating is a big and healthy event. With schools and other organizations not providing an alternative, I could see more trick or treaters than recent years if our collective edge is lost.

      Reply
  2. Clive

    I’m really sorry to read about your mother’s fall and injury. And appreciate the recounting of this incident and the subsequent events. They illustrate a great many important and oft-overlooked points.

    The first of which is a generalisation about elder care and how difficult it is. My dad once commented about nursing in the geriatric field having been responsible for his own mother (who lived to be 101 years old) how, if a professional makes a career out of it, they end up becoming, inevitably, as he put it, “as hard a nails”. I wasn’t sure what he meant at the time — I was a lot younger and had little experience of looking after older people — but I know now. The loss of a sense of humanity when you have the kind of burden to shoulder means it is so easy to take emotional short-cuts and end up blanking out the “caring” part of you just through self-protection. I know all-too-well how, after reiterating to my own mother-in-law the importance of doing or not doing particular things — only to find that I’ve been (usually clandestinely) ignored — it is hard to keep from losing the emotional ties which are, in the end, the only things that do really matter.

    The more pressing point is to amplify just how hard it is to create enduring public health responses. Anyone can throw out some slogans. Hectoring or nagging in whatever form those take work, but only work for a while. Eventually, to use an intentional pun, the mask slips, and everyone starts to drift away from compliance if all they’ve had is being chastened and threatened but they’ve not believed or not absorbed the core message.

    I’ve been trying to wrestle with crapified search and locate information on one of the very few successful long-term public health campaigns I’ve seen implemented. It was the “Chrissy” initiative for methamphetamine awareness which ran in NYC in the late 1990’s / early 2000’s. Many, many attempts had been made to reduce harm caused by crystal meth in the city. But trying to bully and whine at Manhattan’s clubland to give up the meth was never, ever going to work. The “Chrissy” campaign was successful because it didn’t even try. It concentrated on information, support and empathy with its target audience. I have seen nothing — absolutely nothing — in the COVID-19 health messaging which treats the people it needs to reach as adults and recognises the disincentives to comply with public health policy in this particular pandemic circumstances. As Yves observed first-hand, failure is almost guaranteed as a result.

    Reply
    1. AEL

      This is exactly the same problem found in industrial safety engineering. The solution is leadership. Top management has to *constantly* iterate the importance of safety measures. If they let up and stop talking safety and talk about other stuff exclusively, then people quickly get the idea that it isn’t important. Often top executives are shocked when, after a major incident, they learn that they were perceived as being “soft on safety” because they didn’t constantly stress safety and talked about other important issues.

      Reply
    2. wilroncanada

      You need to listen to Dr Bonnie Henry, the British Columbia medical health officer, who, along with the Minister of Health, was giving reports 6 days a week for more then 2 months. She is now down to 3 or 4 times a week,I think. As I mentioned yesterday, she seems to have convinced most of the province to work with her and each other to reduce the damage. She finishes every report with the following: Be kind, be calm, stay safe. (I think I have it in the right order.)
      She says she loves hockey , but is not going to bend the provincial rule of 14 days isolation for those entering the province from outside the country. She is being backed up by the Premier, who had actually called the NHL commissioner originally to have Vancouver put onto the list of possible sites.

      Reply
  3. ambrit

    That’s a shame, as here, in our Mississippi half-horse town, the hospital near us, (there are two decently sized hospitals in this town,) is being strict about visits inside the building. A nurse with ‘instant’ body temperature sensor meets you, takes your temperature and asks you about general health. Then one steps inside the ‘airlock’ inner door and must tell another functionary where you are going in the building, and how long you expect to be inside. Then you sign in, put on an identifying sticker with destination written on it, and only then does the armed guard, (off duty sheriffs officers generally,) allow you inside. Luckily, we haven’t had to use the ER entrance this year, but the nurse said that this protocol was standard for all entrances. Everyone must wear a mask, over half of the people I saw were wearing gloves.
    I was going to the Hospital Pharmacy for Phyl’s pain med. She stopped taking the Lyrica due to severe sleepiness issues, as in twelve to sixteen hours of sleep a day after a month of use. The pain med left is plain old oxycontin, and Phyl is tapering herself off of that.
    I don’t know about your Mom’s pain meds usage, but our experience has been that personal dosage, based on need, has tended to slowly reduce the amount of medication used over time.
    My Mom (87) fell last year and slightly fractured her pelvis, but the doctors determined that it was not bad enough to require surgical intervention.
    Good luck with her recovery and rest assured that, in you, she has the best nurse and healer there is.
    Good wishes from us both to you and your Mom.

    Reply
    1. Yves Smith Post author

      I’m sorry Phyl is having to take so much medication but it sounds like she might be feeling a tiny bit better over time.

      Thanks for all these wishes and as important, good to know I’m not being unduly exercised over the lack of masks and other protocols.

      My mother and I were masked and I even had two plastic shields. She wore one then the other; I mainly wore both but the shield even though brand new isn’t clear enough to read through :-(. One staffer commented favorably on it.

      Re pain meds, I don’t like the idea (well, since opioids not only don’t do much for my pain, but they also make me feel rotten, I am prejudiced). And there is topical anesthetic (Lidoderm, which is prescription Lidocaine patches) which a friend who had back surgery swears by. I am hopeful that stabilizing the back in and of itself will also help. She is only in pain if she lies on her side or goes from reclining to sitting or the reverse. So she’s not in pain until she does something that hurts.

      Reply
      1. ambrit

        It is very good that your Mom has a position that she can be comfortable in.
        From what I have read, the older we get, the longer it takes to heal fractures.
        Is your Mom’s reaction to opioids the same as yours? Can such be a family trait? For example, alcoholism is a family curse in my family. As a result, I don’t drink away from the house, and even then, limit myself to the equivalent of the “hot toddy” before retiring to bed.
        I would observe that the mask and glove “sloppiness” of the hospital you went to is an indicator of a culture of unprofessionalism in the administration of said hospital. I would be leery of anything that hospital does for you or your Mom. Laxness is a fast spreading malady, especially during times of stress.
        Be vigilant, stay safe.

        Reply
      2. Susan the other

        It’s nomb – but I really wish you would check into getting yourself innoculated with BCG. You’d have to take precautions for 2 days to add clorox to the john as sometimes there is a live one; and also take your own temp for a week. Your mother would be isolated by the fact that she is confined to her bed for the most part. Given the fact that you are her caregiver it is a good precautionary measure for her as well as for you.

        Reply
        1. Yves Smith Post author

          I’m told BCG isn’t a great idea to take now. It is administered to infants within days of birth. It could actually increase Covid-19 risk. I suggest reading the full article. Key section:

          The coronavirus itself is not what kills people. What kills people with coronavirus infection is an excessive, overly robust inflammatory response by the immune system that creates a cytokine storm. [A cytokine is a large group of proteins, peptides or glycoproteins that are secreted by specific cells of the immune system. A cytokine storm is an overreaction of the body’s immune system.] People die because their immune systems respond too robustly to the virus, in an overly inflammatory way. The very reason that BCG helps infants has the potential, in my mind, to push the immune system to respond non-specifically and excessively. This could actually be detrimental, and cause people to have more severe disease from the virus. The recent report from China that low-level TB infection is associated with severe COVID disease is concerning, because BCG is a live bacteria that is closely related to the TB bacteria and could have a similar effect on exacerbating severe COVID disease.

          https://caravanmagazine.in/health/bcg-vaccine-covid-immunity-caution

          Reply
      3. Antagonist Muscles

        Maybe a week or two ago, I recommended to Lambert to try ski goggles. No, they don’t cover your face as fully as the face shield, but they are designed to seldom fog up while doing visually intense activities. Of course, you would still have to wear an N95 mask.

        It’s not just the clarity of the face shield that causes visual problems for reading. Those face shields are also a cylindrical piece of polycarbonate. This is going to introduce visual distortion and unpredictable reflections. In contrast, most ski goggles have a spherical lens. If you can handle the aggressive look, try military style tactical goggles or dirt biking goggles.

        Reply
    2. marku52

      My experience with a Dr visit inside the local hospital is similar (SE OR)

      Nurse and guard at the door taking temps, asking for symptoms, you must be masked (they all are, some are eye shielded as well. They ask who you are seeing, and give you a name badge.

      Every one is masked. I was pleased to see it.

      Unfortunately the RW here is clamoring to “Open it up, it hasn’t been that bad”. Well, true, it hasn’t been that bad. And shutting down (until we figure out what part of shut down is necessary, might be why.

      I think our second wave will be worse than the first.

      Reply
      1. ambrit

        Add the amplifying effect to infections of the ‘surge’ in group activities after the ‘shutdown’ ends to what seems to be a natural effect of the second wave of an epidemic being worse than the first wave, means I fully agree with you.
        The coming second wave is going to be devastating.

        Reply
  4. skippy

    Yves … in a number of years I’ve been called down 2 houses to pick my father in law off the floor more times than I can recall, sometimes due to grog and others a miss step – point being is the old coot keeps plugging along regardless.

    Not to long ago at his B-day party it was a standing joke that his perspective of being done with it all and ready to depart would only mean lingering due too it – gods are cruel …

    Heck not too long ago he went down and pranged his head and was laying on his back with about 100 mils of bright red blood around his head – nothing life threatening but a sight to see.

    I guess what I’m trying to say and failing is your love for your mother and circumstances are not what you would like, acerbated by covid19 and your own personal aliments – is a pickle. That said your are doing everything you can within your power to fulfill any reasonable obligation in the duty of care considering the larger dynamic wrought by decades of neoliberalism.

    Please do look after yourself.

    Reply
    1. Amfortas the hippie

      aye. picking stepdad up off the floor is the most effective verbal defense when him and mom get all puritan and hysterical about work being done around here(he doesn’t get up til well after noon, she gets up, but lingers in tv/greentea land til 10…and I’m usually laboring away at sunup, done by 1…lol. so they simply do not notice all the work being done).
      he’s in a wheelchair(vietnam), and is much less mobile than he used to be, and has settled into a routine with the nasty boxwine. But I’ve been on call for rescuing him for 25 years.
      he also no longer drives…so i just forget to obtain the whiskey he orders…and we’re a beer only county, so obtaining the wine comes with lots of ready excuses, too.

      as for the current situation with hospitals…wife and i have recent experience with the oncology clinic—nothing but good things to report.
      but my dad…350 miles away in clear lake, tx…is experiencing Hyponatremia…he’s had heart issues for a long while…and i noticed the cognitive changes months ago…but the low sodium came to a head this month.
      hospital for the second time in 3 weeks…stepmom has back issues, so can’t pick him up when he falls…and his headstrong automatic intransigence means he wanders and falls and drinks 4 times as much water as they want…
      so he’s back in hospital…no one else is allowed in the front door(so stepmom at least can get some rest). she reports that emt’s were crazy about masks and gloves and avoiding covid…so that’s heartening.
      the problem is getting information. Dad is far from lucid….and it’s difficult to get updates when you can be there, face to face(doctor’s rounds have always been pretty random, for whatever reason)…now, by phone, it’s impossible.
      he went back in yesterday…and i don’t expect actual news until monday, given how hospitals function.
      wife’s immediate response to all this is :”we need to go down there”(been more than a year)…but to what end? hanging around with stepmom, waiting by the phone?
      we can do that from here, and with much less risk to ourselves and others.
      Old people are hard…especially if they’re somewhat mobile still.
      when my eldest was tiny, we had my great grandmother living out here at mom’s…and i lucked on to the actual paid job of being her home health person…so i could keep son out of daycare.
      i felt so utterly guilty to be relieved when she could no longer walk….because she had been out of her mind for years, with “mini-strokes” and likely altzheimers….and would wander and resist and try to escape, and so, fall down, etc.
      last year of her life, she was bedridden and stiff as a board…and lost in a recurring loop of memory from circa 1910…a knocked over butterchurn, and hiding under the house from her father….I was relieved(also guilt inducing) when she passed…and i closed her eyes for the last time.
      good luck, Yves.
      hang in there.

      Reply
      1. Billy

        Go to a store and get a “grabber”, it’s a little device with a squeeze handle at the end of a 36″ or so stick and rubber fingers at the end that can grip things.
        Your mom never needs to bend over to pick up small objects, and as a bonus, it can be used to pluck small light things off high shelves, or retrieve things from tight spaces, grab snakes etc.

        Reply
  5. The Rev Kev

    You certainly know how to start a harrowing tale. Mask discipline at Grandview Medical Center appears to be lax at best and dangerous at worse. I am sure that they have a plan for the Coronavirus pandemic but I am also sure that they have not been hit yet. It looks like until they do, that the people that go there will have to maintain the same standards that you do with mask, gloves and all the rest of it. I certainly do not understand people wearing masks that are pulled below their noses. Certainly not ones that work in a hospital in the middle of a pandemic. That is just nuts.

    It’s good that your mother was not more badly injured in her fall but I can imagine the constant worry. A few years ago my late mother fell over and broke her hip in the retirement village that she lived at. It was only the next morning that neighbours going investigating her absence found her and called an ambulance. I am glad that she never lived to go through this pandemic as so many things could have gone wrong. In her state, she never would have understood people not visiting. But with your own mum, I am sure that is a comfort to her to know that she has you to have her back.

    Reply
    1. Antagonist Muscles

      While we are all hammering the idea of public mask usage, allow me to hammer my own point of elderly to take fall prevention classes. I reiterate this to all the elderly people I know. “Take a fall prevention class. Practice simulated (and safe) falls. Practice. Practice! How are you going recognize environments or activities that have higher falling risk? How are you going to react while falling? Or after falling? You must train this.”

      I practice what I preach. Even I sat in for a fall prevention class for elderly. (I’m pretty darn fit.) And just to test my limits, I stand one legged in the shower with two hands on sturdy grip bars and soapy water everywhere under my single leg. Don’t try this at home, kids.

      Reply
  6. Edward

    It sounds like you would have been better off at a different hospital. This may have been an atypical, bad hospital.

    Reply
      1. polar donkey

        The mindset on masks in much of the South is bizarre. Like it is some badge of honor to not wear one. I don’t understand how wearing a mask to prevent the spread of the virus is a trampling of your rights and a sign of weakness. I hear this from most of my extended family. All I can do is shake my head. Eventually a world of pain is going to come to these communities.

        Reply
        1. vlade

          I can, vaguely, understand why somoene would not to wear a mask. What I can’t get my head around is that in the name of _their_ freedom anyone else can’t wear a mask neither. An interesting view of freedom, but then South was a long time “freedom for me, but not for thee”.

          I do wonder – if someone would wilfully sneeze/cough claiming then had CV-19 at you and you shot them, would a Southern judge deem it a self-defense?

          Reply
        2. Edward

          Many Americans seem to have “party-line” thinking or tribal thinking; the highest value is saluting to the group positions.

          Reply
          1. JBird4049

            I know that I am repeating what other have said, but I just have to say that it is just insane, as a virus does not care about politics. Its purpose, as much as it has one, is to survive and reproduce. Add that everyone knows diseases are infectious and many can kill especially if a person is unhealthy or weak what could be gained from not wearing a mask for a little bit? Aside from dying or killing someone else?

            But yes, say anything that doesn’t comport with The Tribe and you are outcast. A dangerous liberal or conservative fool.

            Reply
            1. Edward

              Yes, it is insane, but not that surprising. We have seen similar insanity about global warming, health care, and so on. I think the United States is doing worse then Rome in its imperial decline. Rome’s dramas are still remembered 2000 years later, which makes me think the United States will be infamous 2000 years from now, if humanity survives that long.

              Reply
      2. Edward

        That is disappointing. The hospital could be strong in one area– COPD, and weak in others. From the essay, it sounds like the staff may have an attitude problem as well as a masking (?!) problem.

        I have to say, stories surface now and then indicating problems with the medical profession. Dr. Timothy McCall wrote a book on this subject.

        Reply
      1. Edward

        I did notice those lines in your essay. Maybe all the hospitals in your area are bad and this one is the least bad? I don’t really know; we have limited information about the hospital which can be interpreted in different ways. I have to say, not masking is disturbing because this is a professional issue for medical workers.

        Reply
        1. Yves Smith Post author

          The really big teaching hospital, UAB, isn’t a very nice hospital at all. I don’t know exactly why. I did have to go to a specialized eye ER they have and that was fine (all my ER visits have been for getting my eyeball scratched, which isn’t serious but is monstrously painful and you do need to get an antibiotic cream just in case).

          Maybe UAB is so big it feels chaotic. My mother hates it (even though her MD is a UAB prof and really would prefer her to go their because he has a bit more influence over what happens) and the nurses recommended against it because it’s apparently where Covid-19 patients are being sent.

          There’s another hospital, St. Vincent, which my mother very much liked the one time she stayed there. In retrospect we should have gone there but I didn’t feel I was in a position to second guess the nurses.

          Reply
          1. Edward

            I hope you are able to find some good options. The nurses might have been telling you the truth about Grandview, but its excellence lies in some area other then wearing masks.

            Reply
  7. Notsu

    Hi Yves,

    I’m sorry to hear that your mother was hurt, and that it was so hard to help her. If you think she might fall again, you might look into a Doty belt. I’ve seen my sister, a 51 year old, not-so-fit woman with rheumatoid arthritis, use it to lift our 200-pound weak old dad off the floor after a tumble and put him in a chair.

    Standard disclaimer: I’m not connected to the manufacturer in any way.

    Reply
  8. anon y'mouse

    you have now encountered Alabama medical care, in which a general attitude of “we don’t give a sh__ and don’t want to be here, and none of us are taking this seriously” prevails. and it occurs generally everywhere else as well.

    after living there 5 years and experiencing/observing walk in clinics (which is all that most poor people have access to) and the ICU, i am surprised that one can’t tell from statistics alone that Bama is a craphole where no one seems to care. polite as hell on an individual basis, though.

    sign me “glad to be gone”.

    Reply
  9. ex-PFC Chuck

    “I’m leery of general anesthesia for old people. It appears in some cases to worsen cognitive decline.”

    That occurred in spades with my late father-in-law about 30 years ago. He was 89 at the time. He fell and broke his hip (or perhaps in reverse order) and from the hip standpoint all went well. But after “coming out of the anesthesia” he hallicunated for 48 hours or so. He lived till a few days after his 95th birthday but was never anywhere near the same after that.

    Reply
  10. doug

    Our ER doesn’t allow anyone but the patient in. I was told it is common now. The EMS folks don’t go in anymore, the handoff is outside for now.

    Reply
  11. Mike Mc

    My 92 year old mother was having terrible pain from her osteoporosis weakened vertebrae starting to crush her spinal cord. Her very wonderful GP recommended vertebroplasty surgery: they gave her a local then injected bone cement into three of her cervical vertebrae. In and out of the hospital same day.

    May or may not be useful for your mother, but it made the last three years of my mother’s life fairly pain free which was one of the few blessings she had after a long, happy but hard life.

    Reply
  12. Carolinian

    So sorry to hear of your ordeal from one who has had similar “been there done that” experiences in the past with aging parent and hospital ERs. IMO long before Covid our ER centric approach to all medical complaints–major or minor–was beyond dubious, at least for older patients. Perhaps this accounts for the proliferation of minor emergency clinics in the past few years although I suspect these were seen by hospitals more as a way of scooping in more customers.

    Reply
  13. David in Santa Cruz

    One of the problems with “flattening the curve” is that in most parts of the country nobody knows one of the 100,000 dead. In my small California county (pop 275K), only 2 people have succumbed thus far out of a mere 205 confirmed cases.

    The north county is in fairly close proximity to Silicon Valley (140 deaths from 2700 confirmed cases) and masking has become de rigeur. However, the previously little-affected agricultural south county recently experienced three COVID “clusters,” all connected to large family gatherings held in defiance of the county health order. People had stopped taking the pandemic seriously.

    I have a friend in Silicon Valley whose neighbor, a wealthy 54-year old with no known health issues, died after being diagnosed with COVID. My friend and his family have become religious about following the restrictions…

    Yves, so sorry to learn of your awful day. I hope that your mom can stay comfortable during her recovery.

    Reply
    1. Joe Well

      I am in Massachusetts, where about 1 out of 1000 residents has now officially died of Covid-19 (real number almost certainly much higher) and even here I only know of two very, very distant relatives who have succumbed. No friends or former classmates.

      I wonder how much the age gap in this disease has to do with that (the median age of these deaths in Massachusetts, IIRC, is 82).

      Reply
  14. LAS

    Being a care giver is very difficult, but it is also very rewarding in the end. Best to you both, mother and daughter.

    I have seen some pretty weird mask-wearing behavior on the public transit trains in NYC. Multiple times (!!!) I’ve seen people enter public transit wearing a mask and then when they wish to speak to someone else, they drop the mask. That defeats the whole purpose of wearing the mask. Apparently, to many people it is simply only a social symbol, not a real efficacious item.

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    1. Joe Well

      I had not really understood the phrase “empty virtue signaling” until I saw all the people with masks down below their noses at stores, including especially the store workers.

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  15. Ignacio

    Looks like awareness on Covid 19 risk has not massively arrived to Birmingham. If HC personnel is behaving like this one can guess the rest could be ultrarelaxed about this. Is this true? If so, there is some risk one day an outburst could occur. If at least there is continuous testing at a scale big enough to detect it soon the worst can be avoided.

    Take care!

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  16. antidlc

    ” (I’ve never heard of an ER not allowing an immediate relative to participate in intake and seeing the doctor).”

    My 93 year old mother fell about 5 weeks ago and my brother had to take her to the ER. He had to drop her off at the door and was not allowed to stay.

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      1. PlutoniumKun

        I was talking yesterday to a colleague who’s daughter is a nurse and his wife has a chronic illness so is very vulnerable to Covid. He told me that his daughter finds that by far the most stressful thing about her job now is keeping families and the very sick and elderly apart in hospital and having to provide the emotional support to the sick and ailing that would normally be provided by family visits.

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  17. dk

    The poor mask discipline at a hospital (of all places) could be part of a larger pattern of administrators/employers simply handing down mandates with little or no training or other followup, and often independent of existing procedures. I see this as primarily a failure of management, as in upper management, giving little thought to implementation beyond fiat.

    Store workers become enforcers of social distancing rules (May 7th 2020)
    https://mynbc15.com/news/coronavirus/store-workers-become-enforcers-of-social-distancing-rules-1

    Her [Sandy Jensen, customer service at a Sam’s Club in Fullerton] frustration is shared by store workers across the country, who are suddenly being asked to enforce the rules that govern shopping during the pandemic, a tension-filled role for which most of them have received little or no training. The burden is sure to become greater as more businesses in nearly a dozen states start to reopen.

    Scott Nash, CEO of MOM’s Organic Market, … acknowledges that training for his 1,500 employees has been “on the fly” and that he has not had time to roll out a “training module.” But he tells workers to “use their common sense.”

    It doesn’t help that the general response from the professional medical community has been inconsistent (Fanucci has flip flopped on masks at least twice). Also a general misunderstandings about safety and risk, which have been commodified and cr*pified. Media punditry has a role here too, with exaggeration to the extreme being the key to click-baiting.

    This isn’t meant to excuse individuals from human responsibilities to our communities (each other). But administrators and employers have responsibilities to communities as well, and staff/employees are their agents.

    Injuries to bones can have profound impacts, and certainly when the bones are central to posture. I had written before about my own mom’s fall and subsequent struggles with muscle aches, weakness and fatigue, she’s recently recovered after four months, from what her doctor and physical therapist agree are the consequences of a broken arm and cracked rib. Immobilization is the ideal first phase for bone fractures, but the inevitable loss of vigor from immobility make it particularly dangerous for the elderly. I hope your mother can rest as comfortably as possible during the next few days.

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  18. smoker

    Very glad your mom is back home, and particularly glad she didn’t need an operation. In addition to the anesthesia issues, if the operation may have been scheduled in July, at a Teaching Hospital™:

    06/03/10 The ‘July Effect’: Worst Month For Fatal Hospital Errors, Study Finds – More fatal medication errors happen in July — just when new residents arrive.

    The piece was based on this report: A July Spike in Fatal Medication Errors: A Possible Effect of New Medical Residents

    I’ve witnessed this happen to someone (on MEDI/MEDI) up front, and personal. Major ‘blunder’ made (visible from imaging done by another hospital) by highly recommended/respected California Teaching Hospital. Lucky to be alive – likely alive solely due to the fact they refused some follow-up work by eager newby plastic surgeons wanting to plastic surgery the deadly infected surgery wound.

    The details and subsequent consequences of that clearly non-supervised blunder are far more horrid than what I’ve disclosed.

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  19. Mark Ó Dochartaigh

    I’m sorry to read of your Mother’s injury. She will be sore for awhile now and the older we get the faster we lose muscle tone if we aren’t moving around. I wonder if a physical therapist might help, even if only to maintain arm strength and upper body mobility.

    I was an RN at Parkland back when MRSA was extremely rare and long before community associated MRSA was acknowledged. It first gained a foothold when friends and family members (and the occasional doctor) were noncompliant with wearing ppe. They would visit their injured relative in the trauma ward then go back to sit in the waiting area where the families of patients in SICU/NICU were waiting. And now MRSA kills 20,000 people a year. My cousins in California say that wearing masks is still the rule, but already becoming less common. Here in Florida the name of the game seems to be to massage this quarter’s covid numbers, a typically business-like approach.

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  20. Joe Well

    This is shocking considering that I’ve noticed a media push (no idea by whom) since at least the beginning of May to say that hospitals are now no longer risky places because of all the precuations they’re taking. Here is an example.

    Also, I’m glad that your mother is all right. This gave me flashbacks to when I had to call the ambulance for my grandmother.

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